2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.05A.09 The Accuracy of CT, 18FDG-PET/CT, and Mediastinoscopy for Staging in NSCLC

EP.05A.09 The Accuracy of CT, 18FDG-PET/CT, and Mediastinoscopy for Staging in NSCLC - A Systematic Review and Meta-Analysis

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The document, "The accuracy of CT, 18FDG-PET/CT, and mediastinoscopy for staging in NSCLC - a systematic review and meta-analysis,” investigates the effectiveness of Computed Tomography (CT), 18FDG-PET/CT, and mediastinoscopy in staging non-small cell lung cancer (NSCLC). Conducted by the Grupo Brasileiro de Oncologia Torácica and associated institutions in Brazil, this systematic review and meta-analysis encompass data from 5914 patients across 44 studies regarding CT, 7151 patients across 48 studies regarding PET-CT, and 9630 patients across 34 studies regarding mediastinoscopy.<br /><br />The primary metrics examined include diagnostic sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV). The study utilizes random-effects meta-analysis, and reliability of evidence is assessed using GRADE criteria.<br /><br />Results suggest mediastinoscopy is highly effective for mediastinal staging, boasting a high pooled specificity of 0.99 and sensitivity of 0.80. It is especially recommended where EBUS/EUS is unavailable. 18FDG-PET/CT is suitable for initial evaluations identifying distant tumor sites, but if results are inconclusive, a confirmatory tissue biopsy is advised. It shows a pooled sensitivity of 0.73 and specificity of 0.86. CT scans show limited effectiveness in diagnosing mediastinal lymph nodes, mediastinal staging, and oligometastatic disease identification, with a pooled sensitivity of 0.57 and specificity of 0.77. <br /><br />Overall, while 18FDG-PET/CT is valuable for initial distant assessment and mediastinoscopy for mediastinal staging, CT's accuracy is deemed insufficient for precise staging in NSCLC contexts. The quality of evidence varies, with some methodological limitations recognized across the studies analyzed. Acknowledgments are given to the study authors and supporting organizations, including Bristol-Myers Squibb, AstraZeneca, and Roche.

Asset Subtitle

Vladmir Cordeiro de Lima

Meta Tag

Speaker Vladmir Cordeiro de Lima

Topic Pulmonology and Staging

Keywords

NSCLC

18FDG-PET/CT

mediastinoscopy

staging

diagnostic accuracy

meta-analysis

sensitivity

specificity

GRADE criteria